Fillable Application for Variance or Appeal (City of Buffalo)

Fill Online, Printable, Fillable, Blank Application for Variance or Appeal (City of Buffalo) Form

Use Fill to complete blank online CITY OF BUFFALO (NY) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application for Variance or Appeal (City of Buffalo)

On average this form takes 53 minutes to complete

The Application for Variance or Appeal (City of Buffalo) form is 5 pages long and contains:

  • 1 signature
  • 108 check-boxes
  • 156 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Buffalo

BROWSE CITY OF BUFFALO (NY) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
New York State
Department of State
Division of Building Standards
and Codes
One Commerce Plaza, Suite 1160
Albany, NY 12231-0001
(518) 474-4073
Fax: (518) 486-4487
www.dos.ny.gov
Application for Variance or Appeal
This is an application for a variance or appeal of a local determination regarding applicable
provisions of the New York State Uniform Fire Prevention and Building Code. To be deemed
complete, the application must be signed by the petitioner or authorized agent, must contain all
necessary documentation, be accompanied by the appropriate fee and been reviewed and accepted
by a Regional Office.
The completed application including at least one (1) copy of all required documents must be
submitted to the appropriate Regional Office. For Board of Review petitions, seven (7) additional
copies of all documents shall be delivered to our Central Office in Albany at the address below,
after Regional Office review. A hearing will be scheduled when all required documents are received.
Department of State
Division of Code Enforcement and Administration
One Commerce Plaza
99 Washington Avenue
Albany, NY 12231-0001
(518) 474-4073
Certain variance requests may be treated as routine cases as determined
by the Department in cooperation with the local code enforcement office.
Provide two (2) copies of all required documents to the appropriate
Regional Office.
PART 1 - GENERAL INFORMATION
PETITIONER
(Check one) □ Owner □ Agent □ Architect or Engineer □ Attorney
Name:
Title/Company:
Mailing Address:
Telephone: ( )
-
Fax:
( )
-
Email Address:
PROPERTY □ City □ Town □ Village of County of
Address: Tax Map No.:
Addresses for Department of State Regional Offices and tentative hearing dates can be found on our web site at
www.dos.ny.gov
or by calling (518) 474-4073 during normal business hours.
Mailing an application directly to our Central Office without first involving a
Regional Office will result in a delay.
REGIONAL OFFICE PHONES:
BUFFALO (north) (716) 847-7611
BUFFALO (south)
(716) 847-7612
CAPITAL
(518) 477-7497
FINGER LAKES
(315) 587-4563
KINGSTON
(845) 334-9768
LONG ISLAND
(631) 952-4909
NORTHERN NY
(518) 441-1895
PEEKSKILL
(914) 734-1347
ROCHESTER
(585) 533-1058
SOUTHERN TIER
(585) 437-5534
SYRACUSE
(315) 428-4434
UTICA
(315) 793-2526
PETITION NO:
ROUTINE VARIANCE □
BOARD VARIANCE □
BOARD APPEAL □
(FOR OFFICE USE ONLY)
Owner if other than Petitioner Code Enforcement Official
Name:
Name:
Street Address:
Street Address:
City
: State: Zip:
City
: State: Zip:
Telephone: ( )
-
Telephone: ( ) -
Fax:
( )
-
Fax:
( ) -
Email: Email:
DOS 0311-f (Rev. 06/15)
Page 1 of 7
Application for Variance or Appeal
PART 2 – MINIMUM BUILDING INFORMATION
Height in Stories: Gross Area (all floors): Sq. Ft.: Construction Type:
Occupancy: □ One-Family Dwelling □ Two-Family Dwelling □ Townhouse □ Accessory Structure
□ Other
PART 3 – APPLICABLE BUILDING CODE AND RELIEF REQUESTED (check all that apply)
□ Title 9 - Uniform Fire Prevention and Building Code – Applicable 1/1/1984 to 12/31/2002
□ Title 19 - Uniform Fire Prevention and Building Code – Applicable 1/1/2003 to present
□ Part 1220 Residential □ Part 1221 Building □ Part 1222 Plumbing □ Part 1223 Mechanical
□ Part 1224 Fuel Gas □ Part 1225 Fire □ Part 1226 Property Maintenance
□ Part 1227 Existing Building
□ Multiple Residence Law (MRL)
One the chart below, list the specific code sections which are the subject of your variance request. (use separate sheet if necessary)
□ Variance □ Appeal □ Appeal/Variance
CODE TOPIC RELIEF SOUGHT
SECTION(S)
PART 4 – FILING
NON-REFUNDABLE FILING FEES (please review fee schedule with regional office)
Routine (administrative) variance review process………………………………………………………………………. $ 50
Board of Review Petitions
Construction, alteration or renovation of residential or agricultural occupancies no more than one
structure; no more than 2 dwelling units…………………………………………………………………….. $ 50
Construction, alteration or renovation of other buildings or structures having a gross area of:
● not more than 8,000 square feet…………………………………………………………………………….. $ 100
● more than 8,000 square feet but not more than 25,000 square feet…………………………………….. $ 300
● more than 25,000 square feet but not more than 50,000 square feet…………………………………… $ 500
● more than 50,000 square feet………………………………………………………………………………... $1,000
Maintenance or use of buildings or materials and not otherwise provided for above……………………... $ 100
Checks must be made payable to New York State Department of State. Amount of check: ………………………$
I make this application pursuant to 19NYCRR Part 1205 and I assert under the penalties of perjury that the information
furnished by me in support of this application is true and correct to the best of my knowledge.
Previous Action
Has any previous action related to the subject property been taken by the Department of State or another administrative agency or a
court? (Include any formal interpretations, decisions, orders or informal advisories issued by the Department of State, Division of
Housing and Community Renewal or the Department of Labor).
□ No □ Yes (describe below and provide relevant documents)
□ I request that a hearing before the Board of Review be scheduled on this application for variance or appeal.
SIGNATURE: DATE:
For routine variances, STOP HERE, do not proceed to Page 3
For Board of Review variances or appeals, PROCEED to PART 5 on Page 3
DOS 0311-f (Rev. 06/15)
Page 2 of 7
click to sign
signature
click to edit
Application for Variance or Appeal
PART 5 – ADDITIONAL CONTACT INFORMATION
For Board of Review Variances provide the following names and addresses if applicable:
(attach additional pages if necessary)
PART 6 – BUILDING STATUS AND PROJECT INFORMATION
A. OCCUPANCY CLASSIFICATION (check all that apply for mixed use buildings)
1. Residential Code of New York State [effective 1/1/2003] (see Section 101.2)
□ One-Family Dwelling □ Two-Family Dwelling □ Townhouse
2. Building, Fire, Plumbing, Mechanical, Fuel Gas or Property Maintenance Code of New York State
[effective 1/1/2003]
(see Section 303 of the Building Code of New York State)
Assembly
□ A-1 □ A-2 □ A-3 □ A-4 □ A-5
Business □ B
Educational
□ E
Factory □ F-1 Moderate Hazard □ F-2 Low Hazard
Hazardous
□ H-1 □ H-2 □ H-3 □ H-4 □ H-5
Institutional □ I-1 □ I-2 □ I-3 □ I-4
Mercantile □ M
Residential
□ R-1 □ R-2 □ R-3 □ R-4 □ One or Two-Family Dwelling □ Townhouse
Storage □ S-1 Moderate Hazard □ S-2 Low Hazard
Utility
□ U
Uniform Fire Prevention and Building Code – Title 9B [effective 1/1/1984 – 12/31/2002]
Residential
□ A1 One-Family Dwelling □ A2 Two-Family Dwelling
□ Multiple Dwelling □ B1 □ B2 □ B3 □ B4
Commercial
□ C1 Business □ C2 Mercantile
□ C3 Industrial □ C3.1 Low Hazard □ C3.2 Moderate Hazard □ C3.3 High Hazard
□ C4 Storage □ C4.1 Low Hazard □ C4.2 Moderate Hazard □ C4.3 High Hazard
□ C5 Assembly □ C5.1 □ C5.2 □ C5.3 □ C5.4 (religious) □ C5.5 Educational
□ C6 Miscellaneous (describe):
3. Multiple Residence Law: No. of Stories No. of Dwelling Units Approx. Age: years
Architect or Engineer (if any): Fire Marshal or Inspector
Name:
Name:
Street Address:
Street Address:
City
: State: Zip:
City
: State: Zip:
Telephone: ( )
-
Telephone: ( ) -
Fax:
( )
-
Fax:
( ) -
Email: Email:
Fire Department Contact Person Other Interested Person or Organization
Name:
Name:
Street Address:
Street Address:
City
: State: Zip:
City
: State: Zip:
Telephone: ( )
-
Telephone: ( ) -
Fax:
( )
-
Fax:
( ) -
Email: Email:
DOS 0311-f (Rev. 06/15)
Page 3 of 7
Application for Variance or Appeal
B. BUILDING DESCRIPTION AND PROJECT INFORMATION
Construction Type: If more than one is applicable, specify where each occurs in the building; consult the building code or your
building official for assistance.
□ Residential Code of New York State □ Wood Frame □ Other:
□ Building Code of New York State [Section 602]
□ Uniform Fire Prevention and Building Code [Section 704]
Statistics: Number of stories above a basement: (do not count unfinished attic)
Total floor area of largest story (square feet)
Gross floor area of entire building (square feet)
Date of last Certificate of Occupancy (if applicable)
Project Type/Status: Permit/Compliance Status:
□ New Building □ Building Permit Application Date: / /
□ Addition to Existing Building □ Building Permit Date: / /
□
Repair □ Certificate of Occupancy Date: / /
□
Alteration Level 1 □ Orders or Denials
□ Alteration Level 2 □ Inspection Report
□ Alteration Level 3 Note: Attach all Pertinent Documents
□ Change of Occupancy
□ Other
□ In Planning
□ No Official Allegation of Non-Compliance
□ Work in Progress Start Date: / /
□ Work Completed
PART 7 – SUBJECT OF THE PETITION (appeal and/or variance, both may be requested)
□ APPEAL (check if appealing a code official’s determination)
An appeal is a request for a Board of Review to review any order or determination or the failure within a reasonable time to make any
such order or determination by a Code Enforcement Official. Describe the order or determination and explain specifically why you
believe the order or determination; or failure to act is incorrect, improper or otherwise unwarranted. This should include specific
explanations relative to code sections cited.
Specific Code Section(s) in Question:
A. An order or determination or the failure to make said order or determination in a timely fashion; or the failure to issue a permit or
other document in a timely fashion is appealed. A copy of the order or determination is attached as EXHIBIT .
Briefly describe the order or determination (additional sheets may be used if necessary)
B. Attached as EXHIBIT are the reasons why the order or determination should be reversed or modified or why other relief
should be fashioned so as to do justice among the parties.
DOS 0311-f (Rev. 06/15)
Page 4 of 7
Application for Variance or Appeal
□ VARIANCE (check if requesting a variance)
REQUIRED ARGUMENTS FOR A VARIANCE
The Board of Review may only grant a variance or modification on the basis of one or more of the following six reasons. To be
eligible for a variance you must document that at least one applies to the requested variance or modification.
Strict compliance with the sections described above would entail practical difficulties, unnecessary hardship or would otherwise be
unwarranted because such (check the statements that apply and provide appropriate documentation):
□ 1. would create an excessive and unreasonable economic burden;
Reasons are attached in EXHIBIT
□ 2. would not achieve its intended objective;
Reasons are attached in EXHIBIT
□ 3. would inhibit achievement of some other important public policy;
Reasons are attached in EXHIBIT
□ 4. would be physically or legally impracticable;
Reasons are attached in EXHIBIT
□ 5. would be unnecessary in light of alternatives which, without a loss
in the level of safety, achieve the intended objective of the code;
List alternatives and describe in EXHIBIT
□ 6. would entail a change so slight as to produce a negligible additional
benefit consonant with the purpose of the code.
Reasons are attached in EXHIBIT
PART 8 – DOCUMENTS (for board cases, provide at least 8 copies)
Required Documents: (supplemental to the petition form)
Summary: Describe the project, present conditions, proposed work, details of the appeal and/or variance requests along with
support of the grounds for relief you checked above.
Site Plan: Indicate size and location of all structures on the premises (if applicable).
Building Plans: Drawings in sufficient quantity and quality to clearly describe the requested variance or modification. Such
drawings may include dimensioned floor plans, elevations, sections and construction details. Any drawings submitted should be
identical to those submitted to the code enforcement official or be noted otherwise.
Supplementary Documents: Submit such materials as photographs, charts, reports, detailed descriptions or any other information
that can be used to more fully describe the nature of the request. List any such supplementary materials by Exhibit number:
A hearing will not be scheduled until all required materials are received by the Division of Code Enforcement and
Administration and the appropriate Regional Office has confirmed that the application is complete. All materials must be
received at least three (3) weeks prior to a hearing date.
EXHIBIT NUMBER DESCRIPTION
DOS 0311-f (Rev. 06/15)
Page 5 of 7
New York State
Department of State
Division of Building Standards
and Codes
One Commerce Plaza, Suite 1160
Albany, NY 12231-0001
(518) 474-4073
Fax: (518) 486-4487
www.dos.ny.gov
Uniform Fire Prevention and Building Code Board of Review Petition Instructions
Before you Begin: Prior to completing a petition for the Board of Review, you must first contact the Division’s regional
representative to begin the process. In many cases, an appointment for a site visit is necessary. Failure to first contact a
regional representative can result in a delay in the processing of the variance. Our regional office locations and phone
numbers can be viewed at:
http://www.dos.ny.gov/DCEA/reg_off_cty.html.
Part 1
● Petitioner – The petitioner is the person who signs the form. Indicate whether the petitioner is the owner, agent, etc.
Attorneys, architects, engineers, agents and representatives appearing on behalf of any person, firm, corporation or association
and for which a fee is received, must file a notice to that effect as required by Executive Law, Section 166. A simple letter stating
such is sufficient.
● Property – The actual location of the property, not a mailing address. For a property located in a village or city give the village or
city name. For a property not located in a village or city give the town name. If the property has a name such as “Municipal
Tower” include that name.
● Owner – The name given here is the owner of record of the subject property.
● Code Enforcement Official – Give the name and address of the primary code enforcement agency involved in the subject of the
petition.
Parts 2, 3 and 6
● The code enforcement official should be able to help provide this information. The listing of code sections involved should be as
complete as possible. The Department of State can furnish, on request, a free copy of relevant code sections and information on
purchasing a copy of the complete code. A free online version of the Codes of New York State may be viewed at:
http://publicecodes.cyberregs.com/st/ny/st/index.htm
.
● Copies of all applications, permits, certificates, orders, etc. that are relevant to the petition must be included with the application.
Part 4
● All petitions to a regional Board of Review shall be accompanied by the following fees:
Petitions involving construction, alteration or renovation of residential or agricultural occupancies involving no more than one
structure with no more than two dwelling units ……………………………………………………………………………… $ 50
● Petitions involving construction, alteration or renovation of other buildings and structures:
Not more than 8,000 square feet …………………………………………………………………………………………… $ 100
More than 8,000 square feet but less than 25,000 square feet ………………………………………………………… $ 300
More than 25,000 square feet but less than 50,000 square feet ………………………………………………………... $ 500
More than 50,000 square feet ………………………………………………………………………………………………. $1,000
● Petitions related to maintenance or use of buildings or materials or any petition not otherwise provided for above…. $ 100
● Enclose a check, money order or voucher (government agencies only) for the appropriate fee payable to the New York State
Department of State.
● PETITION FEES ARE NON-REFUNDABLE.
● Please provide at least one petition with an original signature.
Part 5
● It is important to provide complete information in this section to ensure that affected parties are notified.
● If architects or engineers are involved in this matter include their names and addresses.
● If there is a separate fire inspector or fire marshal not listed in Part 1 provide this information.
● The name and address of the responding fire department should be available from the code enforcement official or municipal
clerk.
● Include civic organizations such as historical societies or societies for the disabled, government agencies not otherwise listed,
neighbors, tenants, co-owners or their association, or others whose interest may be affected by the Uniform Fire Prevention and
Building Code Board of Review Petition Instructions, property or subject matter at issue. There is no need to repeat any names
and addresses which are otherwise provided.
DOS 0311-f-a (Rev. 06/15)
Page 6 of 7
Uniform Fire Prevention and Building Code Board of Review Petition Instructions
Part 7
● An appeal is a request for a Board of Review to review any order or determination or the failure within a reasonable time to make
any such order or determination by an administrative official charged with the enforcement of or purporting to enforce the
Uniform Code.
● A variance is a request to deviate from one or more provisions of the Uniform Code.
● To obtain a variance a showing must be made which will permit a board to make a finding upon one or more of the six grounds
stated in 19 NYCRR 1205.4 and restated on the petition form. On a separate page or pages state the reasons which support the
petition keeping the following points in mind: If ground one is argued, show by dollars and cents proof not that it is more
expensive to comply but that the expense is burdensome to the point of being undue. If ground two is argued, show how strict
compliance would not obtain that provision’s (not your) intended objective. If ground three is argued, show the origin of the
competing policy and why the Code should yield to that policy. If ground four is argued, fully describe the impediments and
constraints to strict compliance and show why they cannot be overcome. If ground five is argued, clearly state the proposed
alternatives to the Code requirement and show that they are equally safe and proper and do not substantially adversely affect
provisions for health, safety, and security. If ground six is argued, show that the incremental change required to comply results
in an insubstantial advantage to the Code’s objective.
● Be sure to include copies of all relevant documents.
Part 8
● Ordinarily a site plan and building plans should be submitted with the petition. If it is felt that the case can be adequately
presented without plans, it is suggested that Codes Division be called. Please note that the State Education Law requires that
most plans be signed by and stamped with the seal of a New York State licensed engineer or architect. Exceptions to the
requirement for signed and stamped plans include agricultural buildings, renovations or additions costing under $10,000 and
residential structures 1,500 square feet or less in area. If relief is being sought based in part on the historical nature of the
building, full documentation of any relevant designations should be provided.
● The comparison should be made with the latest copy of the site plan or building plans which have been submitted to the code
enforcement agency. Any difference should be explained. Attach additional sheets as necessary.
● Include court actions, other actions as local zoning related requests whether approved or denied and especially other
appearances before these boards.
DOS 0311-f-a (Rev. 06/15)
Page 7 of 7
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Application for Variance or Appeal (City of Buffalo)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document